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A humorous article in the BMJ that describes evidence-based medicine (EBM) as a religion. “Despite repeated denials by the high priests of EBM that they have founded a new religion, our report provides irrefutable proof that EBM is, indeed, a full-blown religious movement.” The article points out one unquestionable benefit of EBM — that some believers “demand that [the drug] industry divulge all of its secret evidence, instead of publishing only the evidence that favours its products.” Of course, you need not believe in EBM to want that. One of the responses to the article makes two of the criticisms of EBM I make: 1. Where is the evidence that EBM helps? 2. EBM stifles innovation.

What really happened to Dominique Strauss-Kahn? Great journalism by Edward Jay Epstein. This piece, like much of Epstein’s work, sheds a very harsh light on American mainstream media. They were made fools of by enemies of Strauss-Kahn. Epstein is a freelance journalist. He uncovered something enormously important that all major media outlets — NY Times, Washington Post, The New Yorker, ABC, NBC, CBS (which includes 60 Minutes), the AP, not to mention French news organizations, all with great resources — missed.

4 Responses to “Assorted Links”

On the Strauss-Kahn thing, it was obviously an attempt to destroy his candidacy for the French elections. I thought I was being cynical when talking about that, but perhaps I wasn’t being cynical enough.

Is it April Fools Day? Or is this a “Special Conspiracy Edition” of Seth’s Blog?

In any case, all these conspiracies make for fascinating reading.

Regarding the DSK story, I remember noticing (but not taking seriously) an odd little news story out of France just hours before the DSK hotel incident. The story, which seemed silly at the time, claimed that DSK was soon gong to be the target of a vicious smear campaign. Within a short time, that story didn’t seem so silly after all.

Re evidence-based medicine, I think the story has great significance. EBM is in in fact nothing more than a way to ignore real evidence in the form of real patients. The fact that EBM has spread like a virulent plague is evidence for the idea that medical doctors are the laziest and most gullible of all the world’s fools.

I’m not sure about the rest of medicine, but I think that psychiatry needs evidence-based medicine (or something like it). Most psychiatrists believe in the effectiveness of antidepressants (and of other psychiatric drugs), despite the fact that a careful analysis of the evidence suggests that these drugs are largely ineffective and often harmful. So.. if EBM is bad, then what approach do we need to reform psychiatry?

I’m not sure about the rest of medicine, but I think that psychiatry needs evidence-based medicine (or something like it). Most psychiatrists believe in the effectiveness of antidepressants (and of other psychiatric drugs), despite the fact that a careful analysis of the evidence suggests that these drugs are largely ineffective and often harmful. So.. if EBM is bad, then what approach do we need to reform psychiatry?

Whether EBM taken as a whole has been beneficial or not I don’t know. I think it has two big effects: 1. Pushing doctors to pay more attention to evidence (helpful). 2. Increasing denigration and dismissal of evidence that doesn’t reach some standard of goodness (harmful). Which effect is larger I don’t know. Are anti-depressants worse than what they replaced? I don’t know. I don’t think psychiatry will make substantial progress until there is better research into the causes of depression and other mental disorders. In contrast to research about symptom relief. Why research into causes is bad I suppose has many answers, among them (a) all the money given to med school professors and others by drug companies (which love reducing symptoms while leaving the source of those symptoms intact, thereby creating a never-ending demand for their product) and (b) the lack of interest in prevention (because prevention is less profitable than cure). That is, all the money and status linked to perpetuating the status quo. I don’t blame EBM for that.